So comes snow after fire, and even dragons have their endings ~ J.R.R. Tolkien, The Hobbit

Sage in 2001, age 2

Everyone needs a hero. I’m luckier than most. In the summer of 2012, I found two.

They arrived as a pair of hoof care specialists of Equine Wellness Services out of Toledo, WA. Bob is the barefoot trimmer and Laura is his wife, holistic horse guru, fecal worm counter, hay tester, chicken herder, and business partner. Bob and his wife Laura brought with them a wealth of experience and knowledge on diet and horse care. It was far more than I was used to in horse professionals. It was refreshing to finally be surrounded by the support of a team well versed in integrative and natural methods.

It was also obvious from our first meeting in 2012 that Bob and Laura had a sincere dedication to the well-being of the horse. At the time, I’d been with my horse Sage for 11 of her 13 years. We’d certainly had our share of “bonding opportunities,” aka health issues. Following a severe episode of impaction colic when she was three, we had resumed what would become a decade-long, arduous quest to find a diagnosis to her mysterious ailments. Since the day she had arrived at my chosen boarding stables as a two year old in September, 2001, she had exhibited a strange set of symptoms that no veterinarian with which I consulted could diagnose (after passing a basic veterinary exam). In 2010, I finally diagnosed her myself based on overwhelming evidence and exhaustive research. It was later confirmed: PSSM, or Polysaccharide Storage Myopathy.

Sage with farrier friend, Bob

The summer I met Bob and Laura, I was simply desperate for someone new to work on my horse’s hooves. I’d recently had my long-time farrier pull off Sage’s shoes after having worn them for almost two years trying to fix her strange, stiff gait (especially hind end). It was decided by a veterinarian that she had thin soles. This was obviously causing her bizarre walk and unwillingness to move out. She did have thin soles, and the x-ray she took seemed enough proof. But putting shoes on her would fix nothing. And it couldn’t cure PSSM, the glucose storage issue in her muscles that is PSSM, but we didn’t know she had that yet. The veterinarian and farrier were not well-educated on PSSM, so it wasn’t even addressed. Out came the shoes. After years of trying barefoot, I finally gave in. When I decided less than two years later that shoes were doing her no good and had them pulled, she was barefoot but immediately tender on dry, hard August ground. I panicked. She was painful on anything hard, and I thought once again that I had chosen the wrong path for my horse. The horse that just couldn’t seem to catch a break. Still, I wanted to return to barefoot now that I knew her issues were primarily due to PSSM. Not flat soles. I was back to seeking out a knowledgeable trimmer. Not an easy task after having already been through multiple farriers in my county in the decade together with Sage. I didn’t know where to turn.

 

Fortunately, my old farrier had been booked solid and couldn’t return to put the shoes on when I had panicked and called him. I calmed down and realized that the better alternative would be to find a farrier who could fit her for protective horse boots. They were an option that I hadn’t yet tried. Ultimately, I just wanted someone to be able to keep Sage sound enough to keep her from being in pain. That’s when I discovered Bob and Laura through a recommendation from a veterinarian I had worked with a few years earlier.

Within a year under the expertise of Bob, Sage had outgrown her old hoof wall with its nail holes and splits in it. She was wearing Easy Care boots for trail rides, and while she couldn’t yet handle standing on large diameter rock and gravel, she had come a long way. But not long enough. I would understand too late how much impact her insulin and blood sugar levels were having on her hoof quality. Honestly, I had juggled so many symptoms and issues with Sage for so long that subconsciously, I was probably taking a much-needed break.

One sunny late Spring day in 2014, with Sage lethargic much of the time, I was discussing with Bob and Laura how it seemed as if Sage had regressed with the PSSM. To add to the mix, we just couldn’t seem to get more depth or thickness of sole in her hooves. It was the key change that we needed for her to be more comfortable barefoot. I increased the exercise as much as possible as I juggled work, young children, and a boarding situation. From all appearances, it worked. A few months later, it looked as if the worst of my troubles with Sage were behind us. The PSSM seemed to stabilize once again under vigilant attention to a strict regimen of various supplements along with consistent exercise. I began heading out with Sage on regular trail rides. Sage, the horse that more than one well-meaning folks had years ago said I should sell (while many others just thought it).

I had begun soaking her hay to reduce its sugar content which meant less problems with PSSM. For the first time in years, her guts were usually normal instead of chronically loose. When she did begin to have intermittent diarrhea again in mid-summer, followed by a minor colic scare, I assumed it was because her hay was being soaked in water that warmed up in the heat of the day. Perhaps it was fermenting and causing her problems when she ate it. We stopped the soaking. With a return to dry hay, her guts improved almost immediately.

Fortunately, her PSSM symptoms did not flare up, and from that I concluded that she must be doing well on the sugar level of this particular batch of hay. Hay changes frequently when you board a horse, and testing each batch wasn’t realistic. Sage was also building up muscle tone from the trail rides. And, I began enjoying my time at this current barn, more than any other before it in our long list of not-so-ideal at-their-mercy boarding stables. It seemed that Sage was happy, too. She would still have occasional off days, but we had come so far from the sensitive two-year old filly with brown liquid continually running down her hind legs, staining her white tail. The horse that almost died from impaction colic. The horse who could barely hold a trot because of some strange muscle disease that would take a decade to diagnose. We had come so far.

Even with all the improvements, though, I couldn’t seem to get Sage completely comfortable barefoot on the concrete or walking across gravel of too large a diameter. I had boots to cover her hooves while riding, but in the gravel turnouts she resisted doing much more than standing. So, in June of 2014, Bob and Laura decided to try the new glue-on shoes from Easy Care. They’d had success with them on their own horse and now felt comfortable applying them on a client’s horse. The plan was to get Sage’s hooves feeling comfortable enough that she would move more and lose weight, something that she wasn’t doing on her own. She had always been an “easy keeper.” As she aged, she got even “easier.” She’d had a blood test that May showing insulin slightly above normal, but the veterinarian was more concerned that she was developing Cushings (even though her ACTH was normal and she always shed out fine). He didn’t like her weight. We all should have been more concerned with the insulin number “slightly above normal.”

The goal was not to leave Sage in glue-on shoes forever but to eventually transition her back to completely barefoot after she had built up a comfortable sole. If she was pain-free in her hooves, she would move more. Sage was almost immediately happier in the thick, rubber shoes. To get her additional exercise, I decided to place her in the rotation of horses turned out in one of several grass turnouts. The “grass” stubble was virtually all dried up, and I chose the deadest, driest one for her for her two hours a day. She would be walking around, grazing the remnants of grass instead of standing still in a gravel paddock. It was almost July, meaning the sugar in any of the grass that was left should be low enough for her to tolerate and not cause a weight gain. My plan was to take her back out of any pasture turnout at the end of August. I knew to avoid the danger increases of spiking sugar levels in the grass when the nights get cool and new grass grows with autumn rains. Sage had been on turnouts and pasture before with far more grass than this small dirt-filled pasture. I wasn’t worried. Besides, the handlers and I could tell that she looked forward to heading up to her new turnout each day. When I had to leave for several days on a family vacation, I didn’t worry about her standing around bored in a paddock. She loved her time grazing stubble.

It didn’t love her back.

The sun was already high and bright when I reached the barn that Monday morning in August. I arrived to find Sage, still in her cushy rubber shoes, standing stiff and looking at me with a painful expression. I knew that look. It came from years of experience and friendship with this horse I loved through and through. I knew immediately something was amiss. She didn’t want to move. She always nickered and came forward when she saw me. This time, nothing but a stare. Sage was in the gravel turnout since it wasn’t her time to be moved to the upper pasture yet. When she finally proceeded to walk towards me only after much coaxing, she pivoted from her hind hooves. I made a mental note. Meanwhile, she was stepping oddly with her right front hoof. It flexed out strangely with every step. Later, I would realize that she was trying to keep the toe from bearing too much weight. The caretakers had walked her to the turnout two hours earlier, but they were used to slow-walking Sage and said they hadn’t noticed anything out of the ordinary. But today she wasn’t just slow. She was lame. Especially in that right front hoof. We hadn’t had a recent trail ride, and the day before was a Sunday. She hadn’t been up in the grass turnouts at all. If she had an injury it would have happened running around in the grass turnout on Saturday, two days earlier. Another mystery. I brought her in slowly from her paddock and cross-tied her in the aisle way. I crouched on the ground in front of her, looking at her hooves and pondering what to do. Do I call the vet, or wait and see if she got better on her own? Still deep in thought, I vaguely heard someone approach from behind. I gave the person a cursory glance and didn’t recognize him at first, standing in the entrance to the aisle way with the sun behind him. I called out a half-hearted hello to whoever it was in the glow of a sunny halo and resumed thinking about my newly arisen, disconcerting situation.  Then I whipped my head back around as I realized who I had just seen. It was Bob, stopping by unannounced to check on Sage’s new glue on shoes and to see how they were holding up. This is what heroes do.

 

How did you know that Sage needed you, I asked. I went on to explain how I had found her, then I let him walk her out a few feet to examine her lameness. We set to work hosing down her hooves and checking her digital pulse. It was elevated in both front hooves, but much stronger in her right front. Both of us were still not thinking laminitis. It wasn’t Spring, it wasn’t Fall, and she hadn’t been grazing on lush, new grass or overeaten grain. Besides, she seemed to be favoring one front hoof, not both. She responded to the cold hosing, and we returned her to her stall still baffled. But having a perplexing situation with Sage was nothing new to me.

The next day I answered my phone. “I’m with Sage. I’d like to pull off the shoes just to see what’s going on with her hooves without them on,” said Bob. I told him that was probably best and that I would be coming by in a couple of hours.

 

The conclusion that Bob came to was that my horse was worse. Sage was 100 percent lame in both fronts by the next morning. By the time my vet arrived and took x-rays, the verdict was easy when we watched her painful, stilted walk out of the stall. I held my breath as I watched her led out of her stall for the veterinarian. Sage was obviously in excruciating pain. It was both confusing and heartbreaking. Laminitis in August with no lush grass, and all we had changed was ceasing the soaking of her hay. Her coffin bone had rotated in both front hooves: 6 degrees in the left and 8 degrees in the right.

Four months after the abnormal result for insulin, Sage had foundered. Perhaps this horse was simply so sensitive metabolically that any insulin resistance – combined with some grass no matter how dry, and the ceasing of the hay soaking – had been enough to put her over the edge. Founder had about as good a prognosis as impaction colic: those horses who couldn’t recover were euthanized. After 13 years of effort trying to fix her, I could still lose her. Sage had already fought and won against the #1 horse killer, colic. But could she beat death twice? As long as she didn’t give up from the pain, as long as she kept trying, she might make it. But this pain was a lot longer lasting than the colic. This pain would go on day after day, week after week, month after month. Bob and Laura made the 45-minute drive almost daily in the beginning. I made an appointment with a veterinary acupuncturist for her earliest opening within the week. Bob and Laura were right behind her for a trim. Because that’s what heroes do. I bought a pair of therapy hoof boots, and she wore them 24×7 for weeks. I would later buy a second pair as a back up and when she wore out the first. After that, I would have both pair repaired by a shoe repair.

Sage, recovering from founder

The vet had left me with bute; without it, Sage barely wanted to move. But painful as it was, movement was critical for circulation and healing. In addition, I mixed into her daily feed everything I knew or had read about that might help: CoQ10, a blend of Chinese herbs for EMS horses, extra vitamin E, extra magnesium, ground up milk thistle seed, extra magnesium, and homeopathic Arnica daily both internal and applied to her hooves. Her stall was at the end of the aisle and, fortunately, closest to the dirt-filled round pen. Each day, the caretakers or myself walked her to and from it wearing her horse boots. Thankfully, she had the soft dirt of the round pen for several hours at a time for much needed time off her throbbing hooves.

Please Sage, don’t make me put you down, I whispered into her ear, more than once. Please hang on.I hadn’t come this far to let my horse go, to end our journey this way with a prolonged and agonizing ordeal. If she wasn’t giving up, then neither was I. I knew my horse wasn’t a quitter, but founder was asking a lot of any horse. And this horse had already survived so much. I had done everything I knew how for years, and still, something went terribly wrong. She hadn’t been eating lush grass, and she hadn’t gotten herself into a bag of grain. Still she was in danger again, after all my efforts and years of diligence. Looking back, it was clear that I had missed various subtle signs and warnings of insulin resistance: beginning to sweat from short rides, beginning to avoid concrete paths for her sore hooves even with her new rubber shoes, her slow and steady increase in weight after we ceased soaking the hay, the billowing pads of fat that had sprung up above her eye sockets. I learned too late that those pads signaled insulin resistance.

Sage would recover from crippled horse with agonizing, stilted movement to one that I could ride within two months. I began with short bareback rides around the arena at a slow walk, booted, and monitoring her progress every day. During her recovery, she had taken up trying to scratch my back whenever possible as if I was another horse. She nuzzled me and rested her head on my shoulder more frequently than ever before. When I mentioned this to Laura, I said that it seemed as if we had become even closer than we had been prior to the founder.

“Well of course you are. A horse who can barely walk, let alone run, knows that they are dead meat. She knows you saved her,” Laura said. She and Bob would later gift me with a new set of hoof therapy boots.

Sage, happy to have recovering founder feet

One year later, I would finally have the trail horse I thought I had bought 14 years earlier. That next August I began once weekly trail rides of about an hour. We started out slow, mostly walking interspersed with some trotting. At first, we avoided steep grades or much more than a walk on the flat. By the third trail ride, I would be trotting and even galloping down the trails on the horse that many people thought or outright told me that I should have sold or put down. Together, we easily crossed narrow bridges, walked over huge jutting tree roots, and stepped over fallen trees even though she was still a relatively green trail horse. She crossed every obstacle I asked of her. It took special people and a variety of supplements and a strict regime of daily exercise and movement, but ultimately the burden to heal was up to Sage. When I retested her insulin and glucose a year post-founder, she was down to a safe value that was on the low end of normal (which I primarily credit to For Love of the Horse herbs). Her coat was shiny and soft, her eyes had a glow, her mane and tail were long and thick. I breathed a sigh of relief. Not only had we made it through severe colic and PSSM, we had now triumphed over potentially life threatening founder.

There are no ribbons hanging off Sage’s stall door, flapping in the breeze, boasting to all who walk by of her many accomplishments. She doesn’t perform fancy dressage moves on command. She doesn’t jump, except over every gigantic obstacle that comes our way. But I know how lucky I am.

I don’t just have two heroes.

I have three.